| |
|
WellSpan Health
Case Management Nurse
Job Location: York, PA
Job Type: Full time (80hrs/2wks)
Department:
Medical Management
Shift:
Days
General Summary:
Under the general supervision of the Supervisor-Case Management, performs a variety of duties and applies utilization and case management techniques to determine the most efficient use of resources to support the provision of appropriate, cost effective and quality health care. Works in a team model (Case Management Nurse and Social Worker teams are assigned to patient care areas) to address patient discharge needs. Provides leadership in the integration of utilization and case management principles throughout the Hospital.
Duties and Responsibilities:
The following are essential job accountabilities:
1 Performs initial reviews for medical necessity and appropriateness of setting for the assigned case load.
2 Conducts concurrent reviews to ensure medical necessity for continued hospitalization and initiates problem-solving techniques as needed to prevent over and/or under utilization.
3 Liaisons between third party payers and the treatment team regarding the identified treatment plan in accordance with contractual guidelines or System policy.
4 Assists the patient care team with the identification and coordination of alternative treatment settings which will provide appropriate care, maintain quality of care and reduce cost.
5 Identifies conditions which requir
Click Here to Apply
WellSpan Health
|
| |
|
|
